Provider Demographics
NPI:1881682961
Name:NORTON, GREGORY ROBERT (DC)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:ROBERT
Last Name:NORTON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:974 73RD ST
Mailing Address - Street 2:SUITE 40
Mailing Address - City:WINDSOR HEIGHTS
Mailing Address - State:IA
Mailing Address - Zip Code:50324-1024
Mailing Address - Country:US
Mailing Address - Phone:515-440-2242
Mailing Address - Fax:515-440-2495
Practice Address - Street 1:974 73RD ST
Practice Address - Street 2:SUITE 40
Practice Address - City:WINDSOR HEIGHTS
Practice Address - State:IA
Practice Address - Zip Code:50324-1024
Practice Address - Country:US
Practice Address - Phone:515-440-2242
Practice Address - Fax:515-440-2495
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-12
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA4884111NN0400X, 111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
No111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA23032Medicare ID - Type Unspecified# FROM BLUE SHIELD
IAT001312Medicare UPIN